Over the last several years, Trauma-Informed Care has gained status in micro and macro settings. Psychotherapists are not the only ones using this approach. Hospitals, schools, court rooms, community mental health settings and others have adopted some form of “what happened to you?” versus “what’s wrong with you?” thinking.
Some have done this voluntarily, others have conformed due to mandates from funding entities such as SAMHSA, the federal Substance Abuse Mental Health Services Administration. As with any transformative, conceptual change, TIC has met with various degrees of success and acceptance.
I have been using a “trauma model” approach from the beginning of my career, 20 years ago. Especially after reading Dr. Colin Ross’ books on treatment and then training at his in-patient treatment program, thinking in terms of “what has this person experienced?” has been the natural way for me to approach assessment, diagnosis and treatment in the many settings where I have worked. These have included in home therapy, residential treatment settings for teens, adults and military personnel, crisis center, private practice and out-patient hospital programs.
Each of these entities have had their own challenges, but always, my greatest challenge has been working with other professionals who seemed stuck in the medical model’s blame and shame thinking.
Symptom-focused assessment and treatment is burdened with a lack of humane thinking too often. I have heard clients and patients called “manipulative”, “needy”, “attention-seeking” and “worthless”, behind closed doors and within ear-shot of the subjects. I have been told “you’ll need to get over that” when I objected to patient-bashing by other therapists, nurses, and doctors. The “prescribers” (those whose licensing qualifies them to “Rx” medications) are held in highest esteem by these systems, in spite of lack of knowledge and apparent practice of compassion toward those in their care.
I have been passionate—to the point of being called (derisively) “Trauma Queen”—about sharing information and understanding with colleagues and clients, alike. In one hospital, I learned to say “grief, loss and anger issues” because the word “trauma” brought rolled eyes and disdainful stares from supervisors.
So, why persist when it seems to annoy most other professionals around me?
I suppose you could call “trauma-informed thinking” my religion. It’s a philosophy, a way of seeing the world and how it works. When you get down to it, TIC is about compassion, pure and simple.
I reject the definitions that say "compassion" is about "pity" for others. That implies me looking down on another. Another definition says that it means "to suffer together". This makes sense to me and resonates with my experiences. One who is compassionate is motivated to help another who is in pain.
I am now in private practice and my focus is on helping those who have come through traumatic life experiences. The distress, discouragement and despair of many clients is quite intense. I listen to accounts of at worst, sadistic and at best, ignorant treatment of my clients as children. Vicarious traumatization—a secondary form of Post-Traumatic Stress response—is a very real effect of my work day. Without the practice of compassion toward myself, my clients and even, their perpetrators, I would not survive a week.
How does being a trauma-informed thinker help? Staying in the mindset that humans act out of their own experiences and the effects of those experiences helps me stay away from negative judgment, assumption of motivation and prediction of future failure. It helps me stay in the present, mindful, if you will, about the tools and support I offer. It gives me a life-line for connection. I believe spirituality is about connection. Connection with myself, my loved ones, my clients, other professionals and the world I’m in. Dis-connection leads to writing off the needs of others and allows me to give up the good work that can be done. Practicing trauma-informed thinking keeps me connected in all the ways that make my work and life, worthwhile.
Have you been required to complete TIC training? Are you struggling with how to apply it in your work and in your life? I invite you to bravely look in the mirror and see how you can improve in your compassionate practice. May you have success.